Accuracy of Focused Assessment with Sonography for Trauma in Diagnosing Abdominal Injuries in Iraqi Emergency Department Settings

Waleed Saadi Ahmed

doi:10.54133/ajms.v9i2.2413

المؤلفون

Waleed Saadi Ahmed Department of Emergency, Al-Yarmouk Teaching Hospital, Baghdad, Iraq https://orcid.org/0009-0000-0988-7654

DOI:

https://doi.org/10.54133/ajms.v9i2.2413

الكلمات المفتاحية:

Abdominal injury، CT scan، Hemoperitoneum، Ultrasonography

الملخص

Background: The focused assessment with sonography for trauma (FAST) has played a pivotal role in the evaluation of patients presenting with abdominal trauma. Despite its proven advantages, the technique demonstrates variable sensitivity and carries certain limitations. Objective: To evaluate the diagnostic accuracy of the FAST scan in detecting emergent abdominal trauma compared to an abdominopelvic CT scan or intraoperative findings. Methods: A total of 228 patients with blunt or penetrating abdominal trauma were included. Following ATLS protocols and adequate resuscitation, patients without higher-priority conditions underwent FAST to detect intra-abdominal free fluid. Results were compared with CT or intraoperative findings to assess diagnostic accuracy. Results: Among 228 trauma patients. Intra-abdominal injuries were confirmed in 39.5% either by CT for stable patients or intraoperative findings for unstable patients. FAST scan identified free fluid in 33.3% of scans, with a sensitivity of 58.88%, specificity of 83.33%, positive predictive value of 69.73%, and negative predictive value of 75.65%. The overall diagnostic accuracy was 73.68%, with an area under the ROC curve of 0.711. Sensitivity was significantly higher in unstable patients than stable patients (p<0.001) and in penetrating trauma compared to blunt trauma (p<0.05). Conclusions: FAST scan shows moderate diagnostic accuracy for detecting intra-abdominal injuries in trauma patients in the ED. Its sensitivity is higher in hemodynamically unstable patients and those with penetrating trauma, while it is lower in stable patients and those with blunt trauma.

التنزيلات

بيانات التنزيل غير متوفرة بعد.

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